Aggression in Huntington's Disease: A Systematic Review of Rates of Aggression and Treatment Methods

Abstract

Aggression is commonly reported in individuals with Huntington's disease (HD). While correlating factors for aggression are often speculated about, features that are associated with, and contribute to, aggression in this population have not been clearly determined. This systematic review investigates rates of aggression and treatment options for aggression in HD. A number of key findings were revealed. Studies reporting on rates of aggression revealed that its prevalence is high, falling between 22 and 66 percent in the majority of studies. Aggression may be more common in males with HD, and is also found in higher rates in individuals who experience frequent falls, have obsessive-compulsive symptoms and suicidal ideation. There is little research investigating antecedents for aggression in HD. A wide variety of psychotropic medications have been reported in the literature to treat individuals with HD and aggressive behaviour. However, due to methodological limitations, no treatment recommendations can be made, based on the current literature. Two non-medication therapies have been investigated, behaviour support and sensory modulation intervention. However, again, due to methodological limitations with these studies, further research is needed before they can be recommended as frontline interventions. This review highlights the need for further methodologically rigorous studies investigating the treatment of aggression in HD.

Genetic architecture for human aggression: A study of gene–phenotype relationship in OMIM

“…mouse model with elevated aggression and exercise was found to ameliorate aggressive behavior through activation of the reeling signaling pathway [Seo et al, 2013]. Aggressive behaviors are common in many neurological and psychiatric disorders including neurodegenerative disorders [Burns et al, 1990;Fisher et al, 2014;Oh et al, 2015], developmental disabilities [Rojahn et al, 1993], schizophrenia [Sandyk, 1993], bipolar disorder [Ballester et al, 2012], ADHD [Cha et al, 2015],and autism [Pivovarciova et al, 2014]. Epidemiologic and molecular genetic studies show that many disorders share genetic variants in common, suggesting common underlying molecular mechanisms [de Lacy and King, 2013;Lichtenstein et al;Smoller et al, 2013].…”

Characterisation of aggression in Huntington's disease: rates, types and antecedents in an inpatient rehabilitation setting

“…, Bushman & Anderson , Fisher et al . ). It is as an externalised behaviour that can be directly observed and measured via observation from carers, family members and hospital staff (Fisher et al .…”

“…It is as an externalised behaviour that can be directly observed and measured via observation from carers, family members and hospital staff (Fisher et al . ). A recent systematic review has revealed high prevalence rates for aggression, across multiple samples, ranging between 22–66% of HD sufferers (Fisher et al .…”

“…A recent systematic review has revealed high prevalence rates for aggression, across multiple samples, ranging between 22–66% of HD sufferers (Fisher et al . ). In a number of studies, even rates of aggression have been found across both genders in HD (Pflanz et al .…”

“…However, there is presently no empirical data reporting on precipitating, antecedent or triggering events for aggressive behaviour in HD sufferers (Fisher et al . ).…”